Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine

Mohit P. Chopra, Reid D. Landes, Kirstin M. Gatchalian, Lisa C. Jackson, August R. Buchhalter, Maxine L Stitzer, Lisa A. Marsch, Warren K. Bickel

Research output: Contribution to journalArticle

Abstract

During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs. daily attendance and single-day 50% dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC = escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. VC resulted in better 12-week retention (85%) compared to MC (58%; p = 0.009), but neither differed from SC (76% retained). After adjusting for baseline differences in employment, and compared to SC, the MC group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence (p = 0.030), while the VC group had 2 more total weeks of abstinence (p = 0.048). Drug use results suggest that both the interventions were efficacious, with effects primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.

Original languageEnglish (US)
Pages (from-to)226-236
Number of pages11
JournalExperimental and Clinical Psychopharmacology
Volume17
Issue number4
DOIs
StatePublished - Aug 2009

Fingerprint

Buprenorphine
Cocaine
Opioid Analgesics
Appointments and Schedules
Urinalysis
Pharmaceutical Preparations
Counseling
Urine
Costs and Cost Analysis

Keywords

  • buprenorphine
  • cocaine
  • community reinforcement approach
  • contingency management
  • opiate or opioid dependence

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Psychiatry and Mental health

Cite this

Chopra, M. P., Landes, R. D., Gatchalian, K. M., Jackson, L. C., Buchhalter, A. R., Stitzer, M. L., ... Bickel, W. K. (2009). Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine. Experimental and Clinical Psychopharmacology, 17(4), 226-236. https://doi.org/10.1037/a0016597

Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine. / Chopra, Mohit P.; Landes, Reid D.; Gatchalian, Kirstin M.; Jackson, Lisa C.; Buchhalter, August R.; Stitzer, Maxine L; Marsch, Lisa A.; Bickel, Warren K.

In: Experimental and Clinical Psychopharmacology, Vol. 17, No. 4, 08.2009, p. 226-236.

Research output: Contribution to journalArticle

Chopra, MP, Landes, RD, Gatchalian, KM, Jackson, LC, Buchhalter, AR, Stitzer, ML, Marsch, LA & Bickel, WK 2009, 'Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine', Experimental and Clinical Psychopharmacology, vol. 17, no. 4, pp. 226-236. https://doi.org/10.1037/a0016597
Chopra, Mohit P. ; Landes, Reid D. ; Gatchalian, Kirstin M. ; Jackson, Lisa C. ; Buchhalter, August R. ; Stitzer, Maxine L ; Marsch, Lisa A. ; Bickel, Warren K. / Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine. In: Experimental and Clinical Psychopharmacology. 2009 ; Vol. 17, No. 4. pp. 226-236.
@article{ad693ff146b841bda123d5782206c9ac,
title = "Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine",
abstract = "During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs. daily attendance and single-day 50{\%} dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC = escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. VC resulted in better 12-week retention (85{\%}) compared to MC (58{\%}; p = 0.009), but neither differed from SC (76{\%} retained). After adjusting for baseline differences in employment, and compared to SC, the MC group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence (p = 0.030), while the VC group had 2 more total weeks of abstinence (p = 0.048). Drug use results suggest that both the interventions were efficacious, with effects primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.",
keywords = "buprenorphine, cocaine, community reinforcement approach, contingency management, opiate or opioid dependence",
author = "Chopra, {Mohit P.} and Landes, {Reid D.} and Gatchalian, {Kirstin M.} and Jackson, {Lisa C.} and Buchhalter, {August R.} and Stitzer, {Maxine L} and Marsch, {Lisa A.} and Bickel, {Warren K.}",
year = "2009",
month = "8",
doi = "10.1037/a0016597",
language = "English (US)",
volume = "17",
pages = "226--236",
journal = "Experimental and Clinical Psychopharmacology",
issn = "1064-1297",
publisher = "American Psychological Association Inc.",
number = "4",

}

TY - JOUR

T1 - Buprenorphine Medication Versus Voucher Contingencies in Promoting Abstinence From Opioids and Cocaine

AU - Chopra, Mohit P.

AU - Landes, Reid D.

AU - Gatchalian, Kirstin M.

AU - Jackson, Lisa C.

AU - Buchhalter, August R.

AU - Stitzer, Maxine L

AU - Marsch, Lisa A.

AU - Bickel, Warren K.

PY - 2009/8

Y1 - 2009/8

N2 - During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs. daily attendance and single-day 50% dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC = escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. VC resulted in better 12-week retention (85%) compared to MC (58%; p = 0.009), but neither differed from SC (76% retained). After adjusting for baseline differences in employment, and compared to SC, the MC group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence (p = 0.030), while the VC group had 2 more total weeks of abstinence (p = 0.048). Drug use results suggest that both the interventions were efficacious, with effects primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.

AB - During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs. daily attendance and single-day 50% dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC = escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. VC resulted in better 12-week retention (85%) compared to MC (58%; p = 0.009), but neither differed from SC (76% retained). After adjusting for baseline differences in employment, and compared to SC, the MC group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence (p = 0.030), while the VC group had 2 more total weeks of abstinence (p = 0.048). Drug use results suggest that both the interventions were efficacious, with effects primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.

KW - buprenorphine

KW - cocaine

KW - community reinforcement approach

KW - contingency management

KW - opiate or opioid dependence

UR - http://www.scopus.com/inward/record.url?scp=69049098954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=69049098954&partnerID=8YFLogxK

U2 - 10.1037/a0016597

DO - 10.1037/a0016597

M3 - Article

C2 - 19653788

AN - SCOPUS:69049098954

VL - 17

SP - 226

EP - 236

JO - Experimental and Clinical Psychopharmacology

JF - Experimental and Clinical Psychopharmacology

SN - 1064-1297

IS - 4

ER -